title: Portraits of patient cognition: how patients understand diabetes self-care.
abstract: Diabetes self-management is a complex dynamic process. Although patients are given guidelines for self-care, many still struggle with glucose control. This study uses techniques from naturalistic decision-making research to examine how patients with low, moderate, and good glycemic control conceptualize self-care. Eighteen people with type 2 diabetes were interviewed about their experiences with diabetes, understanding of the disease, and self-care behaviour. Qualitative methods were used to analyze responses and describe patterns of cognition. The authors describe participants' understanding of major areas of self-care and its relationship to self-management. The majority of participants failed to adequately understand the disease, typically because they were overwhelmed by or misunderstood rule-based instructions. Understanding of the dynamics underlying glucose regulation was found to be critical for effective self-management. Diabetes educators need to teach patients about the dynamics underlying self-management and to emphasize problem-solving and decision-making skills.
authors.affiliation: Wright State University, Dayton, Ohio, USA.
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Lippa
authors.forename: Helen Altman
authors.initials: HA
authors.lastname: Klein
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D015190:Blood Glucose Self-Monitoring / Q000523:psychology; D003071:Cognition; D032882:Comprehension; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000517:prevention & control* / Q000523:psychology*; D003927:Diet, Diabetic / Q000523:psychology; D015444:Exercise / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research; D010353:Patient Education as Topic; D011340:Problem Solving; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin